New Developments on Patient Centered Medical Home
There were two developments in the continuing efforts to evaluate, define, and promote the Patient Centered Medical Home (PCMH) concept. Both were a bit discouraging. The first development was the release of the results from the National Demonstration Project (NDP) for the PCMH. This project, which started in 2006 and was the first national test of the PC-MH, studied the ability of 36 practices to transform their practice into a PCMH while existing in our current healthcare system. Half of the groups were facilitated and half were self-directed.
The summary produced reports intended to answer four key questions: (1) Can the NDP model be built?(2) What does it take to build the NDP model? (3) Does the NDPmodel make a difference in quality of care? and, (4) Can theNDP model be widely disseminated?
Their conclusion was that it was more difficult to build the PCMH than expected, outcomes were only modestly improved, and patient satisfaction actually suffered. However, since this was the first national project, their groups led the way, which always means mistakes are made and lessons are learned. Using the lessons learned, practices coming along behind them were able to accomplish the task more quickly and with much better results.
Their final recommendation was to “focus on the need for the PCMH model to continueto evolve, for delivery system reform, and for sufficient resourcesfor implementing personal and practice development plans. Inthe meantime, we find that much can be done before larger healthsystem reform.”
The second development was the release of NCQA’s Draft Standards for PCMH for 2011. The NCQA standards are an attempt to define the PCMH, primarily to help payers determine which practices would qualify for specialized reimbursement if and when reimbursement reform actually happens.
Previous NCQA standards were criticized for being too focused on IT, so the 2011 standards were revised to first incorporate the concepts of the PCMH and then imbed necessary IT functions. On the surface the 2011 standards appear almost impossible to accomplish. However, the NIHN staff has reviewed it, broken it down into its component parts, and found that it isn’t as daunting as it first looked. The NIHN staff is dedicated to identifying solutions that will assist physicians in accomplishing the goal to become a PCMH.
The Patient Centered Medical Home has proven its value and has the potential to significantly improve patient care and satisfaction while helping to control skyrocketing healthcare costs. Accomplishing the goal of becoming a PCMH is challenging, but the NIHN is dedicated to helping physicians make it happen.
